PROVIDENCE, R.I. For the first time on a national scale, a team led by Brown University researchers has traced the connections between state nursing home policies and a critical decision in the care of nursing home residents whether to send these frail elderly to the hospital.

In their groundbreaking analysis, researchers found that state policies unwittingly create financial incentives for nursing homes to hospitalize residents even though hospital stays can be disorienting or dangerous. Previous studies have shown that about one-third of hospital stays by nursing home residents can be prevented.

This study which included virtually every nursing home in the nation with 25 or more beds resulted in two major findings. The lower the state Medicaid reimbursement rate to nursing homes, the more likely those homes were to hospitalize residents. Hospitalization odds were also significantly higher in states that reimburse nursing homes for holding the beds of hospitalized residents. Results are published in the current online edition of Health Services Research.

"The message is clear: State policies have a significant impact on the lives of very vulnerable people," said Orna Intrator, an associate professor of community health at Brown and the lead author of the article. "While hospital stays can be life saving for nursing home residents, they remove these seniors from familiar surroundings and expose them to life-threatening infections."

The study was led by Vincent Mor, chairman of Browns Department of Community Health, and conducted by faculty in the Universitys nationally recognized Center for Gerontology and Health Care Research.

For the project, Mor and the study team investigated the affects of two types of state policies on nursing home hospitalizations. One was Medicaid payment policies, which determine how much homes are paid per resident, per day for care through the federal program for the poor and disab'"/>

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